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題 名 | 孕哺期類風濕性關節炎治療新選擇=New Choice of Treatment for RA Patients during Pregnancy and Lactation |
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作 者 | 游佳玲; 江俐慧; 蔡慈貞; 卓偉民; | 書刊名 | 藥學雜誌 |
卷 期 | 35:1=138 2019.03[民108.03] |
頁 次 | 頁69-75 |
分類號 | 418.29 |
關鍵詞 | 類風濕性關節炎; 懷孕; Certolizumab pegol; CZP; Tumour necrosis factor inhibitors; |
語 文 | 中文(Chinese) |
中文摘要 | 類風濕性關節炎是一種全身性自體免疫疾病,臨床上以多個關節滑膜組織慢性發 炎和關節破壞為主要特徵。類風濕性關節炎常發生在正值生育年齡的婦女,為了控 制疾病進展並預防進一步的關節或器官損傷,常需要長期使用免疫抑制治療。臨床 上,在懷孕時期仍需要使用藥物治療。主要的治療藥物如:methotrexate,卻不建議 使用在妊娠哺乳期間。抗腫瘤壞死因子 (tumour necrosis factor inhibitors, TNFi) 生物製 劑是目前被認為可作為妊娠期間,活動性類風濕性關節炎的替代治療選擇。但是, 相關生物製劑臨床經驗太有限,安全性資料不夠令人信服。Certolizumab pegol (簡稱 CZP,商品名為 Cimzia) 是抗腫瘤壞死因子生物製劑,結構特殊僅含有 PEGylation 之 Fab' 部位,並缺乏 Fc 部位,理論上不會穿過胎盤進入胎兒。本文以現有文獻回顧探討 CZP,在懷孕及授乳的類風濕性關節炎病人使用的安全性。最終結論建議懷孕或哺乳 的類風濕性關節炎病人可以考量 CZP 作為治療選擇之一。 |
英文摘要 | Rheumatoid arthritis is a systemic autoimmune disease characterized by chronic inflammation of synovial and multiple joints destruction. Rheumatoid arthritis often affects childbearing age women. To keep disease activity under control and prevent joint or organ damage, long-term immunosuppressive therapy is required in these patients. There is a need for adequate disease control during pregnancy. MTX is teratogenic and should be avoided during pregnancy and lactation. Tumour necrosis factor inhibitors (TNFi) are considered compatible with use during pregnancy. However, the clinical experience of biological agents is too limited to have safety for pregnancy and lactation. Certolizumab pegol is a pegylated Fc-free anti-TNF drug. Certolizumab pegol prevents to transfer across the placenta, because there is lack of the Fc fragment. This review considers certolizumab pegol treatment is safe for pregnancy and breast-feeding women. All these results support continuation of certolizumab pegol treatment for RA patients during pregnancy and breast feeding. |
本系統中英文摘要資訊取自各篇刊載內容。